Background: Empyema thoracis is a condition in which pus and fluid from infected tissue collects in the pleural cavity. Childhood empyema is an important complication of bacterial pneumonia. The incidence of empyema is increasing worldwide. Despite being recognized since the ancient times, the appropriate management of paediatric empyema thoracis remains controversial. Aims & objectives: 50 patients were included in the age group of less than 12 years with the diagnosis of empyema. All the patients were analysed for the clinical course of the disease, radiological investigations, pleural fluid biochemical and microbiological parameters, and various treatment options. Short term follow up was done for complications and sequelae. Subjects and Methods: 64% of the children were under 4 years of age. Males outnumbered females with a ratio of 1.17:1. 74% of the cases were recorded during spring and early summer. 64% of the cases belonged to lower socioeconomic strata. Fever, cough and hurried respiration were the predominant symptoms and the duration of illness of 80% of the cases was 7 -14 days. 64% of our patients had received antibiotics prior to admission. Pneumonia predisposed to empyema in 48% of the cases. 56% of the cases had protein energy malnutrition and 2% were severely malnourished. Left sided empyemas (54%) were more frequent than the right (46%). 46% of the patients had culture positivity on pleural fluid. The commonest organism isolated was staphylococcus aureus (18%). Conclusion: Management of primary empyema continues to be controversial in terms of duration of antibiotic therapy and the indications for and timing of surgery.
Background: Empyema thoracis is a condition in which pus and fluid from infected tissue collects in the pleural cavity. Childhood empyema is an important complication of bacterial pneumonia. The incidence of empyema is increasing worldwide. Despite being recognized since the ancient times, the appropriate management of paediatric empyema thoracis remains controversial. Subjects and Methods: 50 suspected cases of empyema after admission had a detailed history taking as per the proforma, with emphasis on duration of symptoms, previous medication, contact history of tuberculosis and course of illness before admission. Result: In the present study, 21/50(42%) were managed with ICD and antibiotics. Another 21 cases (42%) were managed by ICD with fibrinolytics. Eight cases required thoracostomy and decortication due to poor lung expansion with persisting fever and developed multiple loculations after initial mode of treatment. Amount of pus drained was 700-1000 ml. The time taken for fever to subside ranged from 4-12 days. Conclusion: Emphasis should be laid on minimizing the duration of hospital stay to bring down expenditure, psychological stress and more importantly nosocomial infections due to multidrug resistant organisms.
Dengue is the most important emerging tropical viral disease of humans and leading cause of death in SEAR after diarrhea and acute respiratory infections. It is a significant public health concern with its geographical distribution becoming worldwide, involving nearly all the tropical and subtropical regions of the world with significant morbidity and mortality. This study mainly aims at finding out the factors which were associated with severe dengue fever that helps determining the prognosis in children. This case control study was done during November 2017 to October 2018 from the children admitted in Pediatric ward, Vijayanagar institute of medical sciences, Ballari. Among the 201 study subjects, the factors like presence of bleeding manifestations(p˂0.001), low pulse pressue˂20 mmhg(p˂0.001), prolonged capillary refill time(p<0.001), low O2 saturation(p<0.001), Hyponatremia(p=0.008), elevated SGOT/SGPT levels(p<0.001), Prolonged PT/APTT/INR levels(p<0.001), respiratory and abdominal involvement in the form of pleural effusion, pneumonia and ascites(p<0.001) were significantly associated with severe dengue fever with mortality of 15%. Leucopenia, thrombocytopenia and raising hematocrit was not found to have significant association with the severity of dengue fever in this study. These parameters may be used to predict, to forecast disease severity in patients suspected of dengue infection and to manage it early in the course of the illness. Various measures for early diagnosis and prompt intervention with emphasis on the warning signs and good supportive care would help decrease the fatality and morbidity associated with Dengue.
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